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CC BY-NC-ND 4.0 · World J Nucl Med 2016; 15(03): 161-166
DOI: 10.4103/1450-1147.167605
Original article

Detection of primary malignancy and metastases with FDG PET/CT in patients with cholangiocarcinomas: Lesion-based comparison with contrast enhanced CT

Youssef Elias
Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA
,
Aladin Mariano
Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA
,
Yang Lu
Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA
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The current National Comprehensive Cancer Network (NCCN) Guidelines consider the role of 2-deoxy-2- 18 F-fluoro-d-glucose positron emission tomography/computer tomography (FDG PET/CT) in the evaluation of cholangiocarcinoma (CCA) as "uncertain," and have recommended contrast enhanced computed tomography (CECT) but not FDG PET/CT as a routine imaging test for CCA workup. We set out to compare the diagnostic performance of FDG PET/CT and CECT in patients with CCA. The retrospective study included patients with CCA who underwent FDG PET/CT and CECT within 2-month interval between 2011 and 2013 in our hospital. Lesion-based comparison was conducted. Final diagnoses were made based on the composite clinical and imaging data with minimal 6-month follow-up. A total of 18 patients with 28-paired tests were included. There is a total of 142 true malignant lesions as revealed by the 6-paired pre-treatment and 22-paired post-treatment tests. On a lesion-based analysis, the sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs), and accuracies of PET/CT and CECT for detection of CCA were 96.5%, 55.5%, 97.2%, 50.0%, 94.1% and 62.2%, 66.7%, 96.7%, 10.0%, 62.5%, respectively. FDG PET/CT detected more intrahepatic malignant and extrahepatic metastases; and had significant higher sensitivity, NPV, and accuracy than CECT, while similar in specificity and PPV. No true positive lesion detected on CECT that was missed on PET/CT, and none of the false negative lesions on PET/CT were detected on CECT. Six patients had paired pretreatment tests, and FDG PET/CT results changed planned management in three patients. Our data suggest that FDG PET/CT detect more primary and metastatic lesions and lead to considerable changes in treatment plan in comparison with CECT.

Keywords

Cholangiocarcinoma - contrast enhanced computed tomography - diagnostic performance - 2-deoxy-2- 18 F-fluoro-d-glucose positron emission tomography/computer tomography - lesion-based comparison


Publication History

Article published online:
19 May 2022

© 2016. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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